Natural history of postterm choriocarcinoma.
OBJECTIVE
To review the 32-year experience of the New England Trophoblastic Disease Center (NETDC) with choriocarcinoma occurring after a term gestation and to evaluate potential prognostic factors using the World Health Organization (WHO) prognostic score.


METHODS
The charts of 44 women who were treated for postterm choriocarcinoma at the NETDC from August 1964 to January 1996 were retrospectively reviewed. Demographic data and details of the clinical course were determined. Potential risk factors, including disease duration, pretreatment human chorionic gonadotropin (hCG) level, sites of metastases and stage, as well as data regarding the infants and previous and subsequent pregnancies, were evaluated.


RESULTS
Five (11%) of the infants suffered significant complications secondary to maternal choriocarcinoma. The time interval from delivery to diagnosis, pretreatment hCG level and sites of metastatic disease were all significant risk factors in predicting outcome. All 31 patients with a WHO score < or = 8 survived, and 6/13 (46%) patients with a WHO score > 8 died.


CONCLUSIONS
Disease duration greater than four months from delivery, pretreatment hCG level > 100,000 mIU/mL, presence of liver or brain metastases, and a WHO score > 8 were all important predictors of outcome in patients with postterm choriocarcinoma.
Rodabaugh
K J
KJ
New England Trophoblastic Disease Center, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
Bernstein
M R
MR
Goldstein
D P
DP
Berkowitz
R S
RS
D000293:Adolescent; D000328:Adult; D002822:Choriocarcinoma / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D006063:Chorionic Gonadotropin / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009367:Neoplasm Staging; D049590:Postpartum Period; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology
D006063:Chorionic Gonadotropin